We’re back with Episode 43 of the Real World Paleo Podcast. Christine talks with Neil Stollman, MD, recognized expert on fecal microbiota transplants (FMT) and c.difficile infections and chairman of the Division of Gastroenterology at Alta Bates Summit Medical Center in Oakland, California. We discuss the colon biome, how antibiotics can alter it and make it easier for c.difficile to occur, and how FMT can replace the biome.

We also delve into the four ways to have an FMT, the often dramatic results, science and FDA regulations for FMT, and the future of stool banking.

Topics:

2:42 How Dr. Stollman became interested in gastroenterology and the colon
3:55 Why he’s doing FMT colonoscopy and dramatic patient story
6:09 Explanation of c.difficile bacteria, its transmission, altered biomes and how FMT helps
11:28 Can FMT be used to treat conditions than c.difficile?
14:03 Are there alternatives to using massive doses of antibiotics to treat serious conditions like sepsis or Lyme Disease that disrupt the microbiome?
18:12 Banking your own stool as a precautionary measure and how does that work?
19:32 Research literature supports the use of FMT to fix recurrent c.difficile and FDA approval
20:50 Clinical trials on other applications of FMT and NIH funding
22:44 The four ways to administer FMT: colonoscopy, tube from top, pills and enemas.
25:58 Risks of FMT colonoscopy and choosing alternatives
26:12 Where is a colonoscopy FMT conducted, anesthesia, duration, and recovery
28:42 The screening process for patients and stool donors and cost of obtaining donor stool
34:28 How quickly do patients see results of an FMT procedure?
35:12 Research on short-term and long-term benefits of FMT and risk of autoimmune conditions
38:50 Follow-up studies, stool banks, and FMT patient registries
40:04 What about FMT enemas and what are the risks of DIY enemas?
44:54 FDA rules and limits for conducting FMTs
47:14 Does health insurance cover FMT?
48:48 How many doctors perform FMT in the US and increasing demand?
52:01 Do you advise patients to take probiotics in supplements and/or food?